{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T23:02:03Z","timestamp":1781478123306,"version":"3.54.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"6","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>Premature thelarche and precocious puberty are frequently diagnosed in girls even below 6 years of age and may be difficult to differentiate in the early stages. A GnRH test is often included in the diagnostic work-up, although interpretation of the GnRH test in girls below 6 years of age is challenging, as no reference interval exists for this age group. The objective is to determine the normal FSH and LH response to a GnRH test in healthy prepubertal girls below 6 years of age.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Design and methods<\/jats:title>\n<jats:p>A standardized GnRH test, baseline reproductive hormones, clinical evaluation and bone age were determined in all participants. Forty-eight healthy normal-weight girls aged 3.5\u2009\u00b1\u20090.2 years (range: 0.8\u20135.9 years) were included. Serum concentrations of LH and FSH were measured before and 30 min after the gonadorelin injection.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The 30-min LH responses (mean\u2009\u00b1\u20092 <jats:sc>s.d.<\/jats:sc>) were 5.2\u2009\u00b1\u20094.0 and 2.9\u2009\u00b1\u20092.5\u2009IU\/L and the FSH responses were 23.3\u2009\u00b1\u200916.2 and 14.5\u2009\u00b1\u200910.3\u2009IU\/L in girls aged 0.8\u20133.0 years and 3.0\u20135.9 years respectively. This corresponds to upper cut-off limits for LH of 9.2\u2009IU\/L (&lt;3 years) and 5.3\u2009IU\/L (3\u20136 years). The stimulated LH\/FSH ratio was 0.23\u2009\u00b1\u20090.19 (range 0.06\u20130.43) and did not correlate with age.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>We found that LH increases up to 9.2\u2009IU\/L during GnRH test in healthy normal-weight girls below 3 years of age and that the stimulated LH\/FSH ratio did not exceed 0.43. Our findings have important implications for appropriate diagnosis of central precocious puberty in girls below 6 years of age.<\/jats:p>\n<\/jats:sec>","DOI":"10.1530\/eje-17-0042","type":"journal-article","created":{"date-parts":[[2017,3,28]],"date-time":"2017-03-28T00:41:26Z","timestamp":1490661686000},"page":"747-753","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":17,"title":["The follicle-stimulating hormone (FSH) and luteinizing hormone (LH) response to a gonadotropin-releasing hormone analogue test in healthy prepubertal girls aged 10 months to 6 years"],"prefix":"10.1093","volume":"176","author":[{"given":"Esben T","family":"Vestergaard","sequence":"first","affiliation":[{"name":"1Medical Research LaboratoryAarhus University, Aarhus, Denmark"},{"name":"2Department of PediatricsRanders Regional Hospital, Randers, Denmark"},{"name":"3Pediatrics and Adolescent MedicineAarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia E","family":"Schj\u00f8rring","sequence":"additional","affiliation":[{"name":"3Pediatrics and Adolescent MedicineAarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Kamperis","sequence":"additional","affiliation":[{"name":"3Pediatrics and Adolescent MedicineAarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin Kastberg","family":"Petersen","sequence":"additional","affiliation":[{"name":"4Department of RadiologyAarhus University Hospital, Skejby, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Rittig","sequence":"additional","affiliation":[{"name":"3Pediatrics and Adolescent MedicineAarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Juul","sequence":"additional","affiliation":[{"name":"5Department of Growth and Reproduction and EDMaRCRigshospitalet, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Kristensen","sequence":"additional","affiliation":[{"name":"3Pediatrics and Adolescent MedicineAarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels H","family":"Birkeb\u00e6k","sequence":"additional","affiliation":[{"name":"3Pediatrics and Adolescent MedicineAarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2017042117401831000_176.6.747.1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-2491"},{"key":"2017042117401831000_176.6.747.2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.99.4.505"},{"key":"2017042117401831000_176.6.747.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0800459"},{"key":"2017042117401831000_176.6.747.4","doi-asserted-by":"publisher","unstructured":"Atay Z Yesilkaya E Erdeve SS Turan S Akin L Eren E Doger E Aycan Z Abali ZY Akinci A The etiology and clinical features of non-CAH gonadotropin-independent precocious puberty: a multicenter study. 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